Ota Kazuhiro, Takeuchi Toshihisa, Ozaki Haruhiko, Harada Satoshi, Kojima Yuichi, Higuchi Kazuhide
2nd Department of Internal Medicine, Osaka Medical College, Japan.
Intern Med. 2015;54(9):1049-52. doi: 10.2169/internalmedicine.54.3987. Epub 2015 May 1.
There are no previous reports of esophageal perforation due to endoscopic submucosal dissection developing into pyothorax. We herein describe a case of esophageal healing following perforation in a 60-year-old woman undergoing esophageal endoscopic submucosal dissection. Post-procedural computed tomography revealed pyothorax in the right thoracic cavity, compressing the right lung. The pyothorax did not improve despite treatment with thoracic drainage because the esophageal lumen was connected to the right thoracic cavity. In order to close the site of esophageal perforation, we inserted a covered self-expandable metal stent. The affected site subsequently healed without complications, allowing the drainage tube and stent to be removed.
既往尚无关于内镜黏膜下剥离术导致食管穿孔并发脓胸的报道。我们在此描述一例60岁女性在接受食管内镜黏膜下剥离术后食管穿孔愈合的病例。术后计算机断层扫描显示右胸腔有脓胸,压迫右肺。尽管进行了胸腔引流治疗,但脓胸仍未改善,因为食管腔与右胸腔相通。为了闭合食管穿孔部位,我们插入了一个带覆膜的自膨式金属支架。随后,病变部位顺利愈合,无并发症发生,引流管和支架得以拔除。